Provider Demographics
NPI:1720039647
Name:COLETTA, DANIEL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:COLETTA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:301 SOUTH MAIN ST
Mailing Address - Street 2:STE 1 SOUTH
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901
Mailing Address - Country:US
Mailing Address - Phone:215-348-3382
Mailing Address - Fax:215-348-9950
Practice Address - Street 1:301 SOUTH MAIN ST
Practice Address - Street 2:STE 1 SOUTH
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901
Practice Address - Country:US
Practice Address - Phone:215-348-3382
Practice Address - Fax:215-348-9950
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2016-05-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD012715E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006587290002Medicaid
B34258Medicare UPIN
PA0006587290002Medicaid